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Individual

DR. JEFFREY LEVINE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
223 N VAN DIEN AVE, RIDGEWOOD, NJ 07450-2726
(201) 447-8375
Mailing address
7 CENTURY RD, PALISADES, NY 10964-1504
(845) 365-1956

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06468000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7862709
NJ
Enumeration date
05/01/2006
Last updated
07/08/2007
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